Mandibulofacial Acrofacial dysostosis
Gene: FOXI3
Reports 21 individuals from 21 unrelated families with heterozygous FOXI3 variants (one hmz report) causing craniofacial microsomia (Goldenhar syndrome) characterized by type II/III microtia, ear dysplasia, preauricular tags, facial asymmetry and other first/second pharyngeal‑arch anomalies. The 18 distinct variants include missense, frameshift, nonsense and in‑frame deletions located in the forkhead domain, nuclear‑localisation signal and intrinsically disordered regions. Luciferase reporter assays showed reduced transcriptional activity for all variants; subcellular localisation studies revealed impaired nuclear import for several NLS variants; and mouse knock‑in models recapitulated ear, mandibular and cranial defects, supporting loss‑of‑function as the disease mechanism. A common trans‑haplotype modifies penetrance, explaining variable expression.Created: 24 Mar 2026, 2:42 p.m. | Last Modified: 24 Mar 2026, 2:42 p.m.
Panel Version: 1.17
Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Phenotypes
Craniofacial microsomia 2, MIM# 620444
Publications
Ten affected individuals from 4 families reported with monoallelic variants, 2 with missense variants affecting the nuclear localisation sequence and 2 with frameshift variants.
The missense variants were associated with isolated microtia with aural atresia and affected subcellular localisation of the protein, while the frameshift variants were associated with microtia and mandubular hypoplasia, suggesting dosage sensitivity.
Rated green but CAUTION for incomplete penetrance. 3 of the 4 families had unaffected carriers. Family 1 in particular had 25 genotyped individuals, of which 15 were carriers, of which 5 were affected.
Sources: LiteratureCreated: 3 Nov 2022, 2:20 p.m.
Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, imprinted status unknown
Phenotypes
Dysostosis with predominant craniofacial involvement (MONDO:0800085)
Publications
Variants in this GENE are reported as part of current diagnostic practice
Phenotypes for gene: FOXI3 were changed from Dysostosis with predominant craniofacial involvement (MONDO:0800085) to Craniofacial microsomia 2, MIM# 620444
Publications for gene: FOXI3 were set to 36260083
Gene: foxi3 has been classified as Green List (High Evidence).
Phenotypes for gene: FOXI3 were changed from Craniofacial microsomia to Dysostosis with predominant craniofacial involvement (MONDO:0800085)
Mode of inheritance for gene: FOXI3 was changed from MONOALLELIC, autosomal or pseudoautosomal, imprinted status unknown to MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Gene: foxi3 has been classified as Green List (High Evidence).
gene: FOXI3 was added gene: FOXI3 was added to Mandibulofacial Acrofacial dysostosis. Sources: Literature Mode of inheritance for gene: FOXI3 was set to MONOALLELIC, autosomal or pseudoautosomal, imprinted status unknown Publications for gene: FOXI3 were set to 36260083 Phenotypes for gene: FOXI3 were set to Craniofacial microsomia Penetrance for gene: FOXI3 were set to Incomplete Review for gene: FOXI3 was set to GREEN gene: FOXI3 was marked as current diagnostic